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Why disease persists: an evolutionary nosology.
1Department of Pediatrics, The University of Chicago, 5841 S. Maryland Ave., MC 5058, IL 60637, USA. r-perlman@uchicago.edu
Medicine, Health Care, and Philosophy
|November 12, 2005
Summary
Evolutionary processes beyond natural selection, like mutation and gene flow, explain persistent diseases. Genetic factors and environmental changes also contribute to the prevalence of human diseases.
Area of Science:
- Evolutionary biology
- Medical genetics
- Population genetics
Background:
- Natural selection is expected to decrease disease incidence and severity.
- However, diseases persist in populations despite evolutionary pressures.
Purpose of the Study:
- To explore the evolutionary mechanisms maintaining disease.
- To understand why natural selection does not eliminate all diseases.
Main Methods:
- Review of evolutionary theory and genetic principles.
- Analysis of factors influencing allele frequencies and disease persistence.
Main Results:
- Mutation, gene flow, pleiotropy, epistasis, and linkage disequilibrium can maintain deleterious alleles.
- Life history strategies and trade-offs can favor traits that increase disease risk later in life.
- Selection acting at different biological levels and environmental changes contribute to disease persistence.
Conclusions:
- An evolutionary perspective is crucial for understanding disease persistence.
- Evolutionary nosology enhances the comprehension of human variation and disease.